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Volume 20.15

On September 14, 2020, CMS released Medicaid payment rates for FY 2021 (beginning October 1, 2020).  The Medicaid hospice payment rates are calculated based on the annual hospice rates established under Medicare.  These rates are authorized by section 1814(i)(1)(C)(ii) of the Social Security Act (the Act), which also provides for an annual increase in payment rates for hospice care services.

National rates, subject to geographical modifications are:
Routine home care (days 1-60)        $   199.51
Routine home care (days 61+)         $   157.69
Continuous home care (hourly)       $     59.71
Inpatient respite care                        $   485.36
General inpatient care                      $ 1,045.66
Details are available here.

HOSPICE ELECTION STATEMENT AND ADDENDUM

The modified election statement and the addendum are effective October 1, 2020.  The National Association for Homecare & Hospice (“NAHC”) has reported that “the only financial penalty that should be imposed for the new condition of payment is when an addendum has been requested and there is not evidence in the medical record of the addendum being provided to the beneficiary/legal representative.

NAHC is presenting a webinar, “The Modified Hospice Election Statement and New Election Addendum, Part 1.”  This webinar is being held on Wednesday, September 16, 2020 at 2:00 p.m.  The webinar is free; however, registration is required.  You can register here.

Objectives:

  • Explain the content requirements of the modified election statement and election statement addendum.
  • Provide an overview of the Immediate Advocacy process to be administered by the QIO.
  • Review key processes and procedures for compliance.
  • List and provide answers to frequently asked questions.

Faculty

  • Katie Wehri, Director of Home Care & Hospice Regulatory Affairs, NAHC
  • Theresa Forster, Vice President, Hospice Policy, NAHC